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Updated: Jul 7, 2026
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Published on: June 16, 2022
Revision cochlear implant surgery in children
Robert D Cullen1, Jose N Fayad, William M Luxford
1Children's Auditory Research and Evaluation Center, House Ear Institute, Los Angeles, California, USA.
Insights
Revision cochlear implant (CI) surgery is common in children, with hard device failure, often due to head trauma, being the primary reason. Auditory performance typically recovers within a year post-revision.
Area of Science:
- Pediatric Otolaryngology
- Biomedical Engineering
- Auditory Implants
Background:
- Cochlear implantation (CI) is a vital auditory prosthetic for children with severe to profound hearing loss.
- Revision surgeries for pediatric cochlear implants (CIs) are necessary but their incidence and causes require detailed examination.
Purpose of the Study:
- To determine the incidence and indications for revision cochlear implant (CI) surgery in pediatric recipients.
- To analyze the pattern of events leading to revision CI surgery in children.
Main Methods:
- A retrospective case review was conducted across two tertiary pediatric CI centers.
- Data collected included reasons for revision, surgical outcomes, complications, auditory performance, and device analyses for pediatric CI patients undergoing revision.
Main Results:
- 11.2% of pediatric CI operations (107 of 952) required revision surgery.
- Hard device failure (46%) was the most frequent indication, often linked to head trauma (41% of hard failures).
- Auditory performance generally returned to or exceeded pre-revision levels within 6-12 months post-surgery.
Conclusions:
- Revision CI surgery is a significant consideration in pediatric CI care, with device failure being a primary driver.
- Head trauma is a notable factor contributing to hard device failure in pediatric CIs.
- Counseling families on expected auditory performance recovery post-revision is crucial, acknowledging potential variability.
Objective:
To determine the incidence of revision cochlear implant (CI) surgery in children and the indications for revision surgery and to examine the pattern of events that lead to revision CI surgery.
Study Design:
Retrospective case review.
Setting:
Two tertiary pediatric CI centers.
Patients:
Pediatric CI patients who underwent revision surgery related to their CI.
Main Outcome Measures:
Reasons for revision, surgical outcomes, complications, performance, and device analyses were sought.
Results:
Nine hundred fifty-two pediatric CI operations were performed between 1991 and 2005. Ninety-three patients underwent 107 (11.2%) revision operations. Hard device failure occurred in 46% (n = 49); soft failure occurred in 15% (n = 16); medical/surgical causes were responsible for 37% (n = 40); and magnet dislodgement requiring revision surgery occurred in 2% (n = 2). Head trauma was associated with 41% of the hard failure cases (n = 20). Device analyses revealed identifiable abnormalities in most of both hard and soft failure cases. In most patients, auditory performance equaled or surpassed the best preoperative performance by 6 to 12 months after revision.
Conclusion:
Revision CI surgery is common among pediatric CI recipients. Hard failure is the most common reason for undertaking revision surgery, and this mode of failure is frequently associated with preceding head trauma. Patients and parents should be counseled that performance is expected to equal or surpass the child's best level of performance before revision surgery, although this may take some time, and exceptions do exist.